Systematic Review and Meta-Analysis: Social Media, Suicidal Ideation, and Self-Harm in Children and Adolescents

Objective This study aimed to systematically review and quantify the association of social media use (SMU) and self-injurious thoughts and behaviors (SITBs) in children and youth. Method Searches on MEDLINE, APA PsycInfo, EMBASE, EBSCO CINAHL, EBSCOHost, Web of Science, Scopus, and the Cochrane Library were conducted in January 2025 with no date or language restrictions. Studies were included if they: (1) Involved children and youth (M age ≤ 19 years), (2) Reported on SMU, and (3) Reported on SITBs (self-harm, suicide ideation, suicide attempt). Pooled odds ratios were computed using random effect meta-analyses. Q and I 2 were used to assess study heterogeneity, and meta-regression was used to analyze potential moderators. Risk of bias was assessed using the Joanna Briggs Institute Tool for Cross-Sectional Studies and the Newcastle Ottawa Scale. Results The review included 42 studies (36 unique samples; 147,077 youth, mean age=15.3 ± 1.1; 57.5% female). Greater SMU was associated with higher odds of suicidal ideation (OR = 1.15, 95% CI 1.05-1.26), self-harm (OR = 1.20, 95% CI 1.06-1.36) and suicide attempt (OR = 1.23, 95% CI 1.03-1.47). Effects were moderated by measure type (ideation), region (self-harm), and publication year (self-harm, attempt). Of studies included in at least one meta-analysis, 38% (9/24) used a validated measure to assess SITBs. Conclusion While current results suggest that higher levels of SMU are associated with greater SITBs among youth, the infrequent use of validated measurement tools and cross-sectional study design limits interpretation and ability to determine causal relationships.